June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Periventricular white matter changes on neuroimaging in children with primary concomitant strabismus
Author Affiliations & Notes
  • Zia Chaudhuri
    Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, Delhi, India
    Vision Research Laboratory, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
  • Karthikeya R
    Medical Retina Division, Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
    Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, Delhi, India
  • Yashvant Singh
    Department of Radio-Diagnosis, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
  • Pratibha Kataria
    Vision Research Laboratory, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
  • Umesh Chandra Garga
    Department of Radio-Diagnosis, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
  • Footnotes
    Commercial Relationships   Zia Chaudhuri None; Karthikeya R None; Yashvant Singh None; Pratibha Kataria None; Umesh Chandra Garga None
  • Footnotes
    Support  Scientific and Engineering Research Board (SERB), Department of Science and Technology (DST), Government of India (GOI) grant number EMR/2016/005829 and SPG/2021/002648; Department of Biotechnology (DBT), GOI grant number BT/MB/Indo-US/VR/02/2013, all with Dr (Prof) Zia Chaudhuri as Principal Investigator
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5430. doi:
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    • Get Citation

      Zia Chaudhuri, Karthikeya R, Yashvant Singh, Pratibha Kataria, Umesh Chandra Garga; Periventricular white matter changes on neuroimaging in children with primary concomitant strabismus. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5430.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Periventricular white matter hyperintensities (PVWH) in T2-FLAIR magnetic resonance imaging (MRI) brain scans of 135 children, with and without primary concomitant strabismus (PCS) and with and without antenatal brain insult (ABI) were retrospectively studied to explore if these changes were more frequently seen in esotropia (ET) and if they were a sequelae of ABI.

Methods : The study cohort comprised subjects with ET (Group 1, ET with ABI, n=22, 2.8±3.2 years, 14 males, Fig 1A and Group 2, ET without ABI, n=25, 5.4±3.1 years, 15 males, Fig 1B), exotropia (XT) (Group 3, XT with ABI, n=11, 4.9±6.0 years, 8 males, Fig 1C and Group 4, XT without ABI, n=29, 9.4±4.0 years, 13 males, Fig 1D) and orthotropia (OT) (Group 5, OT with ABI, n=23, 3.4±3.1 years, 14 males, Fig 1E and Group 6, OT without ABI, n=25, 7.8±4.5 years, 14 males, Fig 1F). T2-FLAIR MRI brain scans (1.5T, Siemens Symphony) were analysed for volume of the PVWH and its anatomic distribution.

Results : All groups with ABI had significantly higher volume of PVWH lesions compared to those without ABI (Group 1 vs 2: 43.35cm3 vs 7.68cm3, p<10-5; Group 3 vs 4: 36.02cm3 vs 8.11cm3, p<10-7; Group 5 vs 6: 36.46cm3 vs 1.95cm3, p=0.002; Fig 1). Among those without ABI, ET and XT subjects had significantly higher volumes of PVWH compared to those with OT (Group 2 vs 6: 7.68cm3 vs 1.95cm3, p=0.003; Group 4 vs 6: 8.11cm3 vs 1.95cm3, p=0.001). Also, in the cohort without ABI, ET and XT had significantly higher volume of PVWH around the ventricular trigone and the occipital horns of the lateral ventricle compared to OT (Group 2 vs 6: 4.75cm3 vs 1.02cm3, p=0.002; Group 4 vs 6: 5.67cm3 vs 1.02cm3, p<10-3; arrowheads in Fig 1). No significant difference was found either in the total volume of PVWH (p=0.86) or its distributions in ET and XT without ABI (all p>0.05).

Conclusions : PVWH were seen universally in the study population, including in neurologically and developmentally normal orthotropic children. In subjects without ABI, those with PCS (ET and XT to a similar extent) had PVWH that were significantly more in volume and had significantly different distribution compared to orthotropes. This novel clinico-radiological correlation opens newer avenues for research into the etiology of PCS.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Fig 1A-F: T2-FLAIR axial brain MRI montage of subjects, ET with ABI (A), ET without ABI (B), XT with ABI (C), XT without ABI (D), OT with ABI (E), OT without ABI (F).

Fig 1A-F: T2-FLAIR axial brain MRI montage of subjects, ET with ABI (A), ET without ABI (B), XT with ABI (C), XT without ABI (D), OT with ABI (E), OT without ABI (F).

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